Revista Española de Cirugía Ortopédica y Traumatología, 2008
... Clínica Os-teoarticular. 2000;3:15-9. 6. Prat A, González M, Trilla A, Asenjo MA. Calidad Asi... more ... Clínica Os-teoarticular. 2000;3:15-9. 6. Prat A, González M, Trilla A, Asenjo MA. Calidad Asisten-cial, atención al usuario y relaciones con los medios de comu-nicación. En: Asenjo MA, editor. ... Rev Cir Esp. 2003;73:104-9. 9. Santiñá M, Prat A, González M, Trilla A, Asenjo MA. ...
One of the possibilities in the reconstruction of severe bone loss in revision total knee arthrop... more One of the possibilities in the reconstruction of severe bone loss in revision total knee arthroplasty is impaction bone grafting with support of a mesh. We report the use of a fascia lata allograft as a biological mesh for keeping involved impacted bone graft in one case of uncontained tibial bone defects.
Journal of Materials Science: Materials in Medicine, 2009
To obtain images of the articular surface of fresh osteochondral grafts using an environmental sc... more To obtain images of the articular surface of fresh osteochondral grafts using an environmental scanning electron microscope (ESEM). To evaluate and compare the main morphological aspects of the chondral surface of the fresh grafts. To develop a validated classification system on the basis of the images obtained via the ESEM. The study was based on osteochondral fragments from the internal condyle of the knee joint of New Zealand rabbits, corresponding to fresh chondral surface. One hundred images were obtained via the ESEM and these were classified by two observers according to a category system. The Kappa index and the corresponding confidence interval (CI) were calculated. Of the samples analysed, 62-72% had an even surface. Among the samples with an uneven surface 17-22% had a hillocky appearance and 12-16% a knobbly appearance. As regards splits, these were not observed in 92-95% of the surfaces; 4-7% showed superficial splits and only 1% deep splits. In 78-82% of cases no lacunae in the surface were observed, while 17-20% showed filled lacunae and only 1-2% presented empty lacunae. The study demonstrates that the ESEM is useful for obtaining and classifying images of osteochondral grafts.
The Journal of Hand Surgery: Journal of the British Society for Surgery of the Hand, 1995
In 1966, Wilhelm published a technique of denervation of the wrist joint based on his own anatomi... more In 1966, Wilhelm published a technique of denervation of the wrist joint based on his own anatomical studies of 1958. Other authors have published their experience in wrist denervations with similar results, but there are some discrepancies in descriptions of the innervation of the wrist.
To determine the behaviour of bone allografts in the treatment of tibial plateau fractures, 20 re... more To determine the behaviour of bone allografts in the treatment of tibial plateau fractures, 20 recipients of frozen bone allograft for a depressed tibial plateau fracture were studied. Incorporation of grafts took place in all cases, and no complication secondary to the allograft use has been detected. To avoid donor site morbidity associated with harvesting iliac crest, the use of frozen bone allograft is a good alternative in the treatment of depressed tibial plateau fractures.
The use of injectable self-setting calcium phosphate cements or soluble glass granules represent ... more The use of injectable self-setting calcium phosphate cements or soluble glass granules represent two different strategies for bone regeneration, each with distinct advantages and potential applications. This study compares the in vivo behavior of two calcium phosphate cements and two phosphate glasses with different composition, microstructure and solubility, using autologous bone as a control, in a rabbit model. The implanted materials were a-tricalcium phosphate cement (cement H), calcium sodium potassium phosphate cement (cement R), and two phosphate glasses in the P 2 O 5 -CaO-Na 2 O and P 2 O 5 -CaO-Na 2 O-TiO 2 systems. The four materials were osteoconductive, biocompatible and biodegradable. Radiological and histological studies demonstrated correct osteointegration and substitution of the implants by new bone. The reactivity of the different materials, which depends on their solubility, porosity and specific surface area, affected the resorption rate and bone formation mainly during the early stages of implantation, although this effect was weak. Thus, at 4 weeks the degradation was slightly higher in cements than in glasses, especially for cement R. However, after 12 weeks of implantation all materials showed a similar degradation degree and promoted bone neoformation equivalent to that of the control group.
La artroplastia total de cadera (ATC) constituye uno de los mayores éxitos de la cirugía ortopédi... more La artroplastia total de cadera (ATC) constituye uno de los mayores éxitos de la cirugía ortopédica, y debe su desarrollo al impulso de sir John Charnley. A pesar de sus excelentes resultados, que sobrepasan el 90% a los 15 años (en el momento actual hay series con más de 30 años 1 ), es una técnica que no está exenta de complicaciones, y una de las más importantes es la luxación protésica ( ). Es un problema difícil que deja al paciente preocupado con su cadera protetizada, al cirujano que ve en entredicho su reputación y a la Seguridad Social expuesta a un sobrecoste considerable.
Reconstruction after the excision of pelvic tumors involving the pelvic ring implies difficult pr... more Reconstruction after the excision of pelvic tumors involving the pelvic ring implies difficult problems. Restoration of the function is difficult and an allograft can be one of the possible solutions. Pelvic allograft is recommended by many authors to reconstruct the pelvic ring following extensive resections of bone tumors. Between 1988 and 1989, we performed hemipelvic resection and allograft reconstruction in 4 patients with pelvic sarcomas. The mean age was 42.3 years (range 38-48), consists of 3 male and 1 female. One case developed an infection and one case showed recurrence, both responding to surgical treatment. Outcome in those cases in which surgery was curative to the primary tumor was satisfactory at 10 years follow-up, with a mean total Enneking score of 25.3 (range 24-27) and a good functional result in Merlé D'Aubigne functional score. Despite the limited number of cases presented, our results added to the reported results in the literature led us to consider that...
Several surgical treatments have been proposed to correct the deformity associated with MWD and a... more Several surgical treatments have been proposed to correct the deformity associated with MWD and alleviate the pain; however, no technique can be named the gold standard. TNC arthrodesis is a safe and effective technique for the treatment of the MWD and can be performed with a dorsal or medial approach;we recommend the dorsal approach. We believe that autologous bone graft provides sufficient stability and internal fixation is not needed. Treatment of MWD is not well-documented in literature; more studies are needed to determine the optimum surgical treatment for this rare disease.
The Journal of Trauma: Injury, Infection, and Critical Care, 1994
There are some controversies in the medical literature about the causes of the anterior interosse... more There are some controversies in the medical literature about the causes of the anterior interosseous nerve (AIN) compression syndrome. The present case is, to our knowledge, the first reported resulting from an extrinsic compression of the AIN from a Robert-Jones type bandage in a patient with a distal end clavicle fracture.
The Journal of Trauma: Injury, Infection, and Critical Care, 1993
In 1985 we began a prospective study of the use of external fixation in the treatment of intra-ar... more In 1985 we began a prospective study of the use of external fixation in the treatment of intra-articular comminuted fractures of the distal end of the radius. A total of 30 patients have been treated by this method, representing 1.3% of the total number of patients treated in the Emergency Unit for a fracture of the distal epiphysis of the radius. The use of external fixation in instable fractures of the distal end of the radius improves the anatomic results. These correlate closely with the overall functional results obtained, which were excellent or good in 82.1% of cases, according to the rating system of Gartland and Werley. The main indications are fractures with a high degree of comminution, displacement, and articular affectation (unstable fractures) in young patients, corresponding to Frykman grades VII and VIII.
The Journal of Hand Surgery: Journal of the British Society for Surgery of the Hand, 1985
The authors use Zancolli's classification for the surgical evaluation of the spastic upper limb. ... more The authors use Zancolli's classification for the surgical evaluation of the spastic upper limb. The paper describes the surgical technique used by the authors in the treatment of twenty-six patients grade III, having a "non-functional hand". After justifying the treatment, the technique is described which includes a time for the elbow to relax the antebrachii flexors and M. Epitrochlearis, a time for defunctioning the pronators and relaxing the flexors by intramuscular tenotomy. Transplantation of the flexors of the wrist is carried out to the extensors of the wrist and fingers. The thumb-in-palm is corrected by a tenotomy of the Adductor and Flexor Pollicis Brevis and transplanting the Brachioradialis to the tendons of the first dorsal compartment.
The best antibiotic regimen for acute prosthetic joint infection, treated without removal of the ... more The best antibiotic regimen for acute prosthetic joint infection, treated without removal of the implant, has not been well-defined. This study describes the use of a protocol based on oral rifampicin combinations to treat 47 cases that were followed prospectively for a 2-year period. The regimen used most commonly was levofloxacin 500 mg/24 h plus rifampicin 600 mg/24 h for a mean duration of 2.7 +/- 1 months. The cure rate was 76.9%, and the only independent risk-factor associated with treatment failure was infection caused by methicillin-resistant Staphylococcus aureus or Enterococcus spp. (OR 17.6, p 0.003). Overall, the results suggested that use of oral antibiotics, including rifampicin, for 2-3 months was a good treatment option.
... Clínica Os-teoarticular. 2000;3:15-9. 6. Prat A, González M, Trilla A, Asenjo MA. Calidad Asi... more ... Clínica Os-teoarticular. 2000;3:15-9. 6. Prat A, González M, Trilla A, Asenjo MA. Calidad Asisten-cial, atención al usuario y relaciones con los medios de comu-nicación. En: Asenjo MA, editor. ... Rev Cir Esp. 2003;73:104-9. 9. Santiñá M, Prat A, González M, Trilla A, Asenjo MA. ...
Revista Española de Cirugía Ortopédica y Traumatología, 2008
... Clínica Os-teoarticular. 2000;3:15-9. 6. Prat A, González M, Trilla A, Asenjo MA. Calidad Asi... more ... Clínica Os-teoarticular. 2000;3:15-9. 6. Prat A, González M, Trilla A, Asenjo MA. Calidad Asisten-cial, atención al usuario y relaciones con los medios de comu-nicación. En: Asenjo MA, editor. ... Rev Cir Esp. 2003;73:104-9. 9. Santiñá M, Prat A, González M, Trilla A, Asenjo MA. ...
One of the possibilities in the reconstruction of severe bone loss in revision total knee arthrop... more One of the possibilities in the reconstruction of severe bone loss in revision total knee arthroplasty is impaction bone grafting with support of a mesh. We report the use of a fascia lata allograft as a biological mesh for keeping involved impacted bone graft in one case of uncontained tibial bone defects.
Journal of Materials Science: Materials in Medicine, 2009
To obtain images of the articular surface of fresh osteochondral grafts using an environmental sc... more To obtain images of the articular surface of fresh osteochondral grafts using an environmental scanning electron microscope (ESEM). To evaluate and compare the main morphological aspects of the chondral surface of the fresh grafts. To develop a validated classification system on the basis of the images obtained via the ESEM. The study was based on osteochondral fragments from the internal condyle of the knee joint of New Zealand rabbits, corresponding to fresh chondral surface. One hundred images were obtained via the ESEM and these were classified by two observers according to a category system. The Kappa index and the corresponding confidence interval (CI) were calculated. Of the samples analysed, 62-72% had an even surface. Among the samples with an uneven surface 17-22% had a hillocky appearance and 12-16% a knobbly appearance. As regards splits, these were not observed in 92-95% of the surfaces; 4-7% showed superficial splits and only 1% deep splits. In 78-82% of cases no lacunae in the surface were observed, while 17-20% showed filled lacunae and only 1-2% presented empty lacunae. The study demonstrates that the ESEM is useful for obtaining and classifying images of osteochondral grafts.
The Journal of Hand Surgery: Journal of the British Society for Surgery of the Hand, 1995
In 1966, Wilhelm published a technique of denervation of the wrist joint based on his own anatomi... more In 1966, Wilhelm published a technique of denervation of the wrist joint based on his own anatomical studies of 1958. Other authors have published their experience in wrist denervations with similar results, but there are some discrepancies in descriptions of the innervation of the wrist.
To determine the behaviour of bone allografts in the treatment of tibial plateau fractures, 20 re... more To determine the behaviour of bone allografts in the treatment of tibial plateau fractures, 20 recipients of frozen bone allograft for a depressed tibial plateau fracture were studied. Incorporation of grafts took place in all cases, and no complication secondary to the allograft use has been detected. To avoid donor site morbidity associated with harvesting iliac crest, the use of frozen bone allograft is a good alternative in the treatment of depressed tibial plateau fractures.
The use of injectable self-setting calcium phosphate cements or soluble glass granules represent ... more The use of injectable self-setting calcium phosphate cements or soluble glass granules represent two different strategies for bone regeneration, each with distinct advantages and potential applications. This study compares the in vivo behavior of two calcium phosphate cements and two phosphate glasses with different composition, microstructure and solubility, using autologous bone as a control, in a rabbit model. The implanted materials were a-tricalcium phosphate cement (cement H), calcium sodium potassium phosphate cement (cement R), and two phosphate glasses in the P 2 O 5 -CaO-Na 2 O and P 2 O 5 -CaO-Na 2 O-TiO 2 systems. The four materials were osteoconductive, biocompatible and biodegradable. Radiological and histological studies demonstrated correct osteointegration and substitution of the implants by new bone. The reactivity of the different materials, which depends on their solubility, porosity and specific surface area, affected the resorption rate and bone formation mainly during the early stages of implantation, although this effect was weak. Thus, at 4 weeks the degradation was slightly higher in cements than in glasses, especially for cement R. However, after 12 weeks of implantation all materials showed a similar degradation degree and promoted bone neoformation equivalent to that of the control group.
La artroplastia total de cadera (ATC) constituye uno de los mayores éxitos de la cirugía ortopédi... more La artroplastia total de cadera (ATC) constituye uno de los mayores éxitos de la cirugía ortopédica, y debe su desarrollo al impulso de sir John Charnley. A pesar de sus excelentes resultados, que sobrepasan el 90% a los 15 años (en el momento actual hay series con más de 30 años 1 ), es una técnica que no está exenta de complicaciones, y una de las más importantes es la luxación protésica ( ). Es un problema difícil que deja al paciente preocupado con su cadera protetizada, al cirujano que ve en entredicho su reputación y a la Seguridad Social expuesta a un sobrecoste considerable.
Reconstruction after the excision of pelvic tumors involving the pelvic ring implies difficult pr... more Reconstruction after the excision of pelvic tumors involving the pelvic ring implies difficult problems. Restoration of the function is difficult and an allograft can be one of the possible solutions. Pelvic allograft is recommended by many authors to reconstruct the pelvic ring following extensive resections of bone tumors. Between 1988 and 1989, we performed hemipelvic resection and allograft reconstruction in 4 patients with pelvic sarcomas. The mean age was 42.3 years (range 38-48), consists of 3 male and 1 female. One case developed an infection and one case showed recurrence, both responding to surgical treatment. Outcome in those cases in which surgery was curative to the primary tumor was satisfactory at 10 years follow-up, with a mean total Enneking score of 25.3 (range 24-27) and a good functional result in Merlé D'Aubigne functional score. Despite the limited number of cases presented, our results added to the reported results in the literature led us to consider that...
Several surgical treatments have been proposed to correct the deformity associated with MWD and a... more Several surgical treatments have been proposed to correct the deformity associated with MWD and alleviate the pain; however, no technique can be named the gold standard. TNC arthrodesis is a safe and effective technique for the treatment of the MWD and can be performed with a dorsal or medial approach;we recommend the dorsal approach. We believe that autologous bone graft provides sufficient stability and internal fixation is not needed. Treatment of MWD is not well-documented in literature; more studies are needed to determine the optimum surgical treatment for this rare disease.
The Journal of Trauma: Injury, Infection, and Critical Care, 1994
There are some controversies in the medical literature about the causes of the anterior interosse... more There are some controversies in the medical literature about the causes of the anterior interosseous nerve (AIN) compression syndrome. The present case is, to our knowledge, the first reported resulting from an extrinsic compression of the AIN from a Robert-Jones type bandage in a patient with a distal end clavicle fracture.
The Journal of Trauma: Injury, Infection, and Critical Care, 1993
In 1985 we began a prospective study of the use of external fixation in the treatment of intra-ar... more In 1985 we began a prospective study of the use of external fixation in the treatment of intra-articular comminuted fractures of the distal end of the radius. A total of 30 patients have been treated by this method, representing 1.3% of the total number of patients treated in the Emergency Unit for a fracture of the distal epiphysis of the radius. The use of external fixation in instable fractures of the distal end of the radius improves the anatomic results. These correlate closely with the overall functional results obtained, which were excellent or good in 82.1% of cases, according to the rating system of Gartland and Werley. The main indications are fractures with a high degree of comminution, displacement, and articular affectation (unstable fractures) in young patients, corresponding to Frykman grades VII and VIII.
The Journal of Hand Surgery: Journal of the British Society for Surgery of the Hand, 1985
The authors use Zancolli's classification for the surgical evaluation of the spastic upper limb. ... more The authors use Zancolli's classification for the surgical evaluation of the spastic upper limb. The paper describes the surgical technique used by the authors in the treatment of twenty-six patients grade III, having a "non-functional hand". After justifying the treatment, the technique is described which includes a time for the elbow to relax the antebrachii flexors and M. Epitrochlearis, a time for defunctioning the pronators and relaxing the flexors by intramuscular tenotomy. Transplantation of the flexors of the wrist is carried out to the extensors of the wrist and fingers. The thumb-in-palm is corrected by a tenotomy of the Adductor and Flexor Pollicis Brevis and transplanting the Brachioradialis to the tendons of the first dorsal compartment.
The best antibiotic regimen for acute prosthetic joint infection, treated without removal of the ... more The best antibiotic regimen for acute prosthetic joint infection, treated without removal of the implant, has not been well-defined. This study describes the use of a protocol based on oral rifampicin combinations to treat 47 cases that were followed prospectively for a 2-year period. The regimen used most commonly was levofloxacin 500 mg/24 h plus rifampicin 600 mg/24 h for a mean duration of 2.7 +/- 1 months. The cure rate was 76.9%, and the only independent risk-factor associated with treatment failure was infection caused by methicillin-resistant Staphylococcus aureus or Enterococcus spp. (OR 17.6, p 0.003). Overall, the results suggested that use of oral antibiotics, including rifampicin, for 2-3 months was a good treatment option.
... Clínica Os-teoarticular. 2000;3:15-9. 6. Prat A, González M, Trilla A, Asenjo MA. Calidad Asi... more ... Clínica Os-teoarticular. 2000;3:15-9. 6. Prat A, González M, Trilla A, Asenjo MA. Calidad Asisten-cial, atención al usuario y relaciones con los medios de comu-nicación. En: Asenjo MA, editor. ... Rev Cir Esp. 2003;73:104-9. 9. Santiñá M, Prat A, González M, Trilla A, Asenjo MA. ...
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